Prevention Component

As the five year ,"Blueprint to House Every Citizen of Colorado Springs," progresses we must move from the reactive mode to the proactive in our efforts to eliminate homelessness. This change of mind set requires us to anticipate those conditions which indicate a likelihood of homelessness and those which immediately precede the condition. Common sense and simple arithmetic show that keeping a person/family from falling into the state of homelessness is incredibly less expensive than re-housing a person/family.

The questions that arise are:

1.) What are the indicators of a propensity toward homelessness?

2.) What can we do to prevent homelessness?

3.) Is intervention economically feasible?

The answer to the first is fairly straightforward. The answer to the second requires a bit more thought. The answer to the third requires some arithmetic applications to determine the social and financial "return on investment" of public funds dedicated to assisting persons at risk.

What are the indicators of a propensity toward homelessness?

This list is not all-inclusive, but here are some important factors:

	1.	Lack of education and/or job skills

	2.	Inability to access health and dental care, including
		cosmetic maintenance

	3.	Unreliable transportation

	4.	Mental illness with no family or support system or access
		to mental health services

	5.	Uncontrolled substance abuse

The first three are less pernicious than the last two, but their danger is that the first sentences one to a life of minimum wage jobs with no insurance and no security. The second makes it highly unlikely that employees are able to conform to the health and aesthetic requirements of employment that offers upward mobility. The third virtually requires that jobs be within walking distance of home, generally to jobs in convenience stores that are close to low income housing. In these situations a broken automobile, a week off with a back injury or day care problems will most likely cost them their job. In a month they're knocking on the door of the shelter. This person/family lives in a crisis mode, often identifying only with the crisis homeless group. Within these first three groups, there is often a better chance of rehabilitation than for those in the last two groups. These first three groups also have a better chance of responding to preventative measures.

Most chronically homeless individuals fall into the latter two categories, often with a co-diagnosis. We are in the process of implementing common sense plans to house these individuals, but how do we prevent their falling into homelessness?

1. Lack of education or job skills

We need to define realistic goals for our educational systems. Should all kids be in a college-prep program? Should everyone study a foreign language in school? For many students, being able to opt into a program of half-day academic and half day vocational training has been a godsend. Even in a public educational system we do have an obligation to match a student's education with his/her desires and abilities. If the answer is not vocational training, could it be an "alternative school" setting where a student of a certain emotional mind set can work at his own pace in a smaller school without the clamor of a traditional high school? Is tutored self-study toward a GED a possibility for the student who is lacking in socialization skills?

The benefits of searching for a job with a high school diploma or a GED in hand are almost literally incalculable.

A program in Upstate New York in the 1970's recruited young men and women of high school age (14-21) who had children. The children were entered into a day-care center run by teachers and early childhood education students on a vocational training campus. The parents spent half a day in academic classes, eating lunch with their kids, and spent the other half of the day in vocational training. They graduated with a high school diploma, vocational training for immediate employment and a great skill-set for raising their children. The usual recidivism rate for out-of-wedlock births was 75%. The rate for graduates of this program was 3%. Multi-generational chains of welfare dependency were broken. These young people worked, raised and supported their children and PAID TAXES.

Could programs of this type be done for adults? The former CETA and JTPA programs provided for job training and educational completion and often integrated adults and high school students in training programs. Some saw this as a problematic situation, but in most cases it proved to be a plus for the high school students who saw the adults as very serious-minded role models, not inclined to tolerate nonsense in the classroom.

We need to make it easier for people to return to their education and training. We need low-tuition or tuition-free programs that will integrate child care into the program. Using the facilities we already have in place (at non-peak hours?) should make the costs reasonable. High standard of conduct, attendance and performance need to be set and adhered to.

2. Inability to access health and dental care, including cosmetic maintenance

The first part is self-explanatory, and is a problem that is best addressed by federal funding programs. Also here we need to discern between homeless, per se, and those who are housed but could be referred to as "working poor," i.e., those with no financial safety net.

The former group is able to receive medical services from organizations like Peak Vista Community Health Centers, through its Homeless Health Center in Colorado Springs. The latter group, however, may not have access to the same services due to the sheer numbers that fall into this category. This is a continuing dilemma.

However, there are a few courageous, caring and sensible entrepreneurs who have studied the problem and are experimenting with solutions. Over the past half-century most of us have been lulled into forgetting what insurance really is: protection against catastrophic experiences or losses. The days of the $2 co-pay for prescriptions and the $5 co-pay for physician's office calls are over. Economic realities are forcing all of us to re-think health insurance. (Dental plans usually cap benefits, and have thus been easier to manage. The problem is "just" that expenses have risen much faster than benefits.)

So what are these creative entrepreneurs doing? Simply put, they were suffering dramatically from high turn-over rates among their employees. (Reference the broken car/back injury comments above.) They calculated the costs of re-training new employees and decided to gamble on applying this amount of money to employee benefits, with health insurance as a first priority.

A program of this type is currently running at Peak Vista and is called the Healthy Workforce Program. Hospital and surgical procedures are not provided. Basic primary preventive medical services are offered as well as some dental services. Employees know that they and their families have access to health care. Employment turn-over rates are dropping dramatically, and the arithmetic aspects of the equation are validated. The "return on investment" is positive; and an ancillary gain accrues to the employer: employee loyalty.

Again, with dentistry, the homeless have access to the basics like extraction and the working poor may not. But what is cosmetic maintenance? It is the correcting of an imperfection that will generally keep one from obtaining a job for which he or she is qualified. Most often, the reference is to dental problems. How often have you been waited on in a service situation by a person with conspicuously missing or decayed teeth, or no teeth at all?

I believe that there are many dentists in our community who would work a half-day a month in a clinic away from their own office. (I also understand their reluctance to invite homeless and working poor to share their waiting room with "paying customers".) Forty dentists could staff a forty hour a week operation year 'round. Perhaps hygienists could be given pro bono time with pay or be hired by the clinic, per se, through community funding. The facilities presently exist for a plan like this.

Health and dental care are large, complicated problems; but by concentrating on what we can do, we will make a difference.

3. Unreliable transportation

Transportation is a concept that so many of us take for granted. Short of making automobiles available to the working poor and homeless, which is quite unrealistic, we must encourage the use of public transportation that is available now, and that which will become available as a result of the passage of the Transportation Initiative in November of 2004. Incentives should be developed for everyone to use public transportation. Then greater usage should lead to better services being available.

4. Mental Illness with no family or support system

A great number, possibly a majority, of chronically homeless individuals suffer from mental illness. A common occurrence is that these illnesses have caused them to become estranged from their families and other support systems. At the time of first contact with a case worker, many of these individuals are incapable of rationally choosing to enter a case management plan. Patience and perseverance are both required of the case worker, and a viable option for these individuals is presently taking shape in our city.

The 2004 Super-NOFA Grant provided $150,000 a year for five years to acquire twenty-five basic housing units for the mentally ill homeless. The only caveat is that a case manager relationship be established whereby someone will generally supervise the individual, see to his or her meds, etc. The problem is that while HUD is most generous with these grants, a 100% match is required to maintain them. This becomes a problem when other grants or private funding cannot maintain the service component. It's a problem we face now in Colorado Springs.

In areas where the funding is more readily available, the results are that these individuals tend to be good tenants, tend to occupy the same housing unit continuously for years, sometimes return to work; and they cost the taxpayers about half as much to maintain in housing as they did on the streets, since their emergency room visits are less as are their encounters with ambulance services, fire and police services.

The situation is nearly the same as with the mentally ill mentioned above. Another S-NOFA Grant has been written and we hope to receive another $750,000 in the Spring of 2005 with twenty-five additional basic housing units for homeless with substance abuse problems. The same format will be followed. One source of clients for this program could be the Harbor House program, another could be graduates of the several rehab programs that are running simultaneously in Colorado Springs.

Again, the key to success in either of these programs is patience and perseverance. These are definitely labor-intensive programs and funding must be found for the case managers to make these programs work.

Allocation of resources and governmental spending patterns are problematic in both the areas of substance abuse and mental illness. As a state, Colorado ranks last in spending for substance abuse prevention. Treatment for substance abuse in our area has been achieved through interagency cooperation and dedication and much private funding. We don¹t spend dollars on substance abuse prevention as a state, but housing those whose lives have been negatively altered through substance abuse is a growth industry in Colorado, i.e., the prison system. We are not exercising fiduciary responsibility in these matters.

Treatment for mental health problems has not even fared as well. Currently we are abysmally lacking in mental health services for our citizens. A paradox is that a mentally ill individual cannot get an appointment and a few hundred dollars per month worth of prescription drugs to maintain stability; but he or she can access the emergency room for treatment of the illness caused by the lack of drugs, often at a cost ten times that of the drugs. We are not allocating our scarce resources, our tax dollars, thoughtfully.

Much has been accomplished in the area of prevention of homeless, but much is still left to accomplish. It will take a concerted effort among federal, state and local agencies to accomplish this task. But two hypotheses that we¹re beginning to be able to prove are that:

1.) putting dollars into prevention is much less expensive than allowing people to fall into homeless and,

2.) when a person or family is homeless, even chronically, is it less expensive to shelter them than to leave them on the streets.

Measure with your heart or measure with your calculator: it's a sound business practice to help the homeless!

FIVE YEAR BLUEPRINT TO HOUSE EVERY CITIZEN OF COLORADO SPRINGS

PREVENTION COMPONENT